title: Prevalence and predictors of persistent versus remitting mood, anxiety, and substance disorders in a national sample of older adults.
abstract: OBJECTIVE
  Relatively little is known about whether mental disorders other than depression remit versus persist in later life, especially within nationally representative samples. Our objectives were to examine the prevalence of persistent mood, anxiety, and substance disorders in older adults and to explore a range of physical and mental health predictors of disorder chronicity.
  
  
  METHODS
  This study involved a 3-year follow-up design using Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Participants included 1,994 adults aged 55 years and older who had a past-year mental disorder at Wave 1 and who completed Wave 2. The primary outcome was the prevalence of persistent mood, anxiety, and substance disorders at Wave 2. Potential predictors of persistence included sociodemographic variables, physical health (chronic health conditions and physical health-related quality of life), and mental health (childhood adversity, suicide attempts, mental health-related quality of life, comorbid mental disorders, personality disorders, and lifetime treatment-seeking).
  
  
  RESULTS
  With the exception of nicotine dependence, the prevalence of persistent mood, anxiety, and substance disorders ranged from 13% to 33%. Only younger age predicted substance disorder chronicity. Significant predictors of persistent mood and anxiety disorders included physical and mental health comorbidity, physical health- and mental health-related quality of life, suicide attempts, comorbid personality disorders, and treatment-seeking.
  
  
  CONCLUSIONS
  At least two-thirds of mental disorders in these older adults were not persistent. Sociodemographic variables had little influence on chronicity, whereas a number of markers of mental disorder severity and complexity predicted persistent mood and anxiety disorders. The findings have important treatment and prevention implications.
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Corey S
authors.initials: CS
authors.lastname: Mackenzie
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Renée
authors.initials: R
authors.lastname: El-Gabalawy
authors.affiliation: Department of Asian and Policy Studies, The Hong Kong Institute of Education.
authors.forename: Kee-Lee
authors.initials: KL
authors.lastname: Chou
authors.affiliation: Department of Psychiatry, University of Manitoba. Electronic address: sareen@cc.umanitoba.ca.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; longitudinal; mental disorders; persistence; remission